使用旋转血栓弹力图对一名患有爱泼斯坦综合征患者进行活体供肾移植的麻醉管理：病例报告
Anesthetic Management of Living-Donor Renal Transplantation in a Patient With Epstein Syndrome Using Rotational Thromboelastometry: A Case Report.
作者信息
Higashi Midoriko, Kaku Keizo, Okabe Yasuhiro, Yamaura Ken
机构信息
From the Departments of Anesthesiology and Critical Care Medicine.
Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
A A Pract. 2020 Nov;14(13):e01350. doi: 10.1213/XAA.0000000000001350.
Epstein syndrome is a myosin heavy chain 9 (MYH9)-related disorder characterized by hearing loss and macrothrombocytopenia with renal failure, which usually requires platelet transfusion during surgery. We report the case of a 22-year-old man who underwent living-donor renal transplantation without platelet transfusion using rotational thromboelastometry (ROTEM) monitoring. His intraoperative laboratory coagulation findings were a platelet count of 28-31 × 10/L based on microscopy and fibrinogen of 256 mg/dL. However, his extrinsic pathway evaluations by ROTEM were normal. The estimated blood loss during the operation was 150 mL, and the patient showed no bleeding complications without platelet transfusion.
爱泼斯坦综合征是一种与肌球蛋白重链9（MYH9）相关的疾病，其特征为听力丧失、巨大血小板减少症并伴有肾衰竭，手术期间通常需要输注血小板。我们报告了一例22岁男性患者的病例，该患者在使用旋转血栓弹力图（ROTEM）监测的情况下，未输注血小板接受了活体供肾移植。他术中实验室凝血检查结果显示，显微镜下血小板计数为28 - 31×10/L，纤维蛋白原为256mg/dL。然而，通过ROTEM评估其外源性凝血途径正常。手术期间估计失血量为150mL，患者未输注血小板也未出现出血并发症。
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